Living will

From ArticleWorld


A living will is a signed and generally notarized document a person completes and provides to relatives and their medical providers that outline their end-of-life wishes. It is also called an advanced healthcare directive and is designed to make one’s wishes known in the event they become incapacitated.

Scope

A living will specifies several things. The individual can decide what kinds of treatment or medication they would want if they are incapacitated and unable to speak for themselves. It sometimes declares a principal or “healthcare power of attorney” to speak for them and an alternate if the principal is not able to make decisions either. Specific things can be refused such as the use of an artificial respirator or the use of CPR in the event of cardiac arrest.

A DNR order is a part of, but does not replace, a living will. A DNR order stands for a “Do Not Resuscitate” order that specifically refers to the refusal to be resuscitated in the event of cardiac arrest. Any care prior to a cardiac arrest is not covered and must be performed to the fullest extent unless otherwise specified in a living will.

A living will can also allow for the refusal of certain medications or therapies under different medical situations, including the refusal of forced feeding or intravenous fluids. In the Netherlands, an individual can sign a special euthanasia directive that allows for them to be euthanized after they have lost their ability to speak for themselves and if they have a terminal condition.

In countries other than the US, several organizations can register these patient decrees so that they are not “lost in the system” at the time of absolute need. Living wills are, unfortunately, not completely binding in the US as are other kinds of wills. Technically, a family can choose not to abide by the living will directive, leading to conflict among caregivers and family. When a living will is called a “will to live”, the implication is that the individual wants to emphasize the will to live for as long as possible and often doesn’t include the refusal of care.

Because of several highly publicized cases involving conflict between family members of a seriously ill patient, doctors recommend that anyone above the age of 18 have an accurate living will in place. A number of organizations or a healthcare provider can help someone fill out a living will form. In the US, it is a requirement that all hospitals ask whether or not a patient has advanced directives and to provide them with information if they do not have one but wish to complete such a process.